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RN, Utilization Case Manager - Archimedes

Navitus Health Solutions

Archimedes

Archimedes - Transforming the Specialty Drug Benefit - Archimedes is the industry leader in specialty drug management solutions. Founded with the goal of transforming the PBM industry to provide the necessary ingredients for the sustainability of the prescription drug benefit alignment, value and transparency Archimedes achieves superior results for clients by eliminating tightly held PBM conflicts of interest including drug spread, rebate retention and pharmacy ownership and delivering the most rigorous clinical management at the lowest net cost. We are committed to providing equal employment opportunity to all applicants and employees and comply with all applicable nondiscrimination regulations, including those related to protected veterans and individuals with disabilities. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, or handicap.

Overview

The RN, Utilization Case Manager will coordinate care between physicians, patients, and pharmacies, facilitating access to specialty medications for patients with complex disease states.

Responsibilities

How do I make an impact on my team?

  • Review chart notes and perform utilization management on patient/drug specific case basis.
  • Coordinate facilitation of patients' specialty drug treatment, ensuring timely delivery to the appropriate site of care.
  • Handle case assignments, review case progress, properly document case notes, and determine case closure.
  • Follow established procedures, processes, and standards for production, productivity, quality, and customer service. Meet performance targets for speed, efficiency, and quality.
  • Complete care management clinical escalations. Escalate to account management as appropriate.
  • Ensure all external and internal customers receive the level of customer service required by Archimedes and serve as a representative of Archimedes to all external customers.
  • Participate in, adhere to, and support compliance, people and culture, and learning programs.
  • Perform other duties as assigned.

Qualifications

What our team expects from you?

  • Education: Associate's degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN) required; BSN preferred. Master of Science in Nursing (MSN) a plus.
  • Certification/Licenses: Current, active Registered Nurse (RN) license in good standing with the applicable State Board of Nursing is required.
  • Experience:
    • Utilization and Case management experience required.
    • Experience in an infusion setting, physician office or pharmacy required.
    • Experience with managing specialty medications for patients with chronic illness is highly preferred.
    • Expert at Microsoft Office Suite.

Benefits

What can you expect from Archimedes?

  • Top of the industry benefits for Health, Dental, and Vision insurance
  • 20 days paid time off
  • 4 weeks paid parental leave
  • 9 paid holidays
  • 401K company match of up to 5% - No vesting requirement
  • Adoption Assistance Program
  • Flexible Spending Account
  • Educational Assistance Plan and Professional Membership assistance

Location

502 Earth City Expy STE 300

City

Earth City

State/Province

MO

Postal Code

63045

Country

US

Navitus Health Solutions
Vacancy posted 3 days ago
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